Jennifer Bray

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH21782 Issued in FL

Practice address

135 Integra Reserve LN Apt 418
Debary, FL 32713-9822

Phone

(702) 845-8088

NPI assigned

Jul 15, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684540800000",
    "number": "1831707975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 INTEGRA RESERVE LN APT 418",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327139822",
            "telephone_number": "702-845-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 INTEGRA RESERVE LN APT 418",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327139822",
            "telephone_number": "702-845-8088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1307 S International Pkwy Ste 2051",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327461414",
            "country_code": "US",
            "telephone_number": "702-845-8088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAY",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2023-05-20",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH21782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birth Mamas
• Samantha Rose Bosack, DC
• Nancy Bourbonnais
• Seth James Bowden, D.C.
• Bridget Michelle Boylan, RBT
• Jennifer Brow, OTR
• Shad M Brown, PA-C
• Addison Page Burkholder
• Joseph V Calderone Jr., D.M.D.
• Ruth Elizabeth Caldwell

• All providers in Debary, FL
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.